AB1060 EXPLORING DISEASE ACTIVITY AND PATIENT CHARACTERISTICS IN ANKYLOSING SPONDYLITIS (AS) IN EUROPE
Authors: D. Baldock, M. Thoo, R. Connolly, E. Baynton
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Ankylosing Spondylitis (AS) is a form of arthritis that primarily affects the spine. It causes inflammation of the spinal joints that can lead to severe, chronic pain and discomfort<sup>[1]</sup>. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is the most frequently used patient-reported outcome to measure disease activity in axial spondyloarthritis. There is no validated definition for disease remission using BASDAI, although a threshold of ≤3 has been used in clinical trials for low disease activity<sup>[2]</sup>. <h3>Objectives</h3> The objective of this study was to examine AS patient characteristics of those with low disease activity (LDA) (BASDAI score ≤3), highlighting any nuances in treating these patients. <h3>Methods</h3> A multi-centre online medical chart review study of patients with AS was conducted between July 2022 – September 2022 among UK, FR, DE, IT &amp; ES rheumatologists practicing across hospital and private practices. Physicians were screened for practice duration and patient volume. Charts of patients prescribed with biologics were included in the analysis. <h3>Results</h3> 262 sampled physicians collectively reported 524 AS patients. From the reported AS patients, 277 were recorded as having achieved LDA ('LDA') and 165 were recorded as not having achieved LDA ('not LDA'). Among not LDA reported patients, a higher proportion were female vs the LDA cohort (32% vs 19%). Reported not LDA patients were more likely to suffer any additional co-morbidities vs LDA cohort (63% vs 44%). When analysing disease severity (physician-defined) status between these two patient groups, reported not LDA patients were more likely to be recorded as 'mild' at diagnosis vs LDA (14% vs 4%). In contrast, current (i.e. at time of consult) disease severity was more likely to be recorded as moderate/severe for the not LDA cohort vs the LDA cohort (76% vs 20%). In addition, reported not LDA patients recorded with higher mean disease and haematology scores. <h3>Conclusion</h3> From the sample surveyed, it appears the not achieved LDA group are milder at diagnosis but show a greater disease severity/activity on their most recent consultation compared to the LDA cohort – it could be inferred that initial mild severity resulted in a lesser need to treat earlier and, as such, disease progression ensued. There may therefore be an argument to treat early with advanced therapies, regardless of initial disease severity. Further investigation using comparator cohort is warranted. <h3>References</h3> [1]Spondylitis Association of America - Ankylosing Spondylitis. 2022. Ankylosing Spondylitis Overview | SPONDYLITIS.ORG. [ONLINE] Available at: https://spondylitis.org/about-spondylitis/overview-of-spondyloarthritis/ankylosing-spondylitis/. [Accessed 23 November 2022]. [2]PubMed. 2022. Minimal disease activity in axial spondyloarthritis: the need of the hour and a proposal for development - PubMed. [ONLINE] Available at: https://pubmed.ncbi.nlm.nih.gov/28376060/. [Accessed 23 November 2022]. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.